CC-16-1759 F Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-271935 Permit Number: CC-6-16-1759
Scheduled Inspection Date: December 22,2016 Permit Type: Commercial Construction
Inspector: Naranjo, Ismael
Inspection Type: Framing
Owner: CHURCH,ST ROSE OF LIMA CATHOLIC Work Classification: Alteration
Job Address:415 NE 105 Street CHURCH BLDG T—'N��
Miami Shores, FL
Phone Number (305)758-0539
Parcel Number 1122310430010
Project: <NONE>
Contractor: QUINTERO GENERAL CONSTRUCTION Phone: (786)487-5738
Building Department Comments
DEMO WALL TILE AND REPLACE NEW ONES, DEMO Infractio Passed Comments
WALLS PARTITIONS AND REPLACE NEW ONES, INSPECTOR COMMENTS False
REPLACE EXISTING LAVATORIES AND REPLACE
EXISTING VANITY TO A NEW ONE.
,Jnspector Comments
Passed CREATED AS REINSPECTION FOR INSP-261726. Need to provide
EZ inspection certification by a Florida license architect or engineer for the
following required inspections.
1.Framing
Failed 2. Drywall.
The certification should reflect the methodology use to perform such
inspections.
Correction
Needed
Re-Inspection ❑ ��� � d�
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
December 21,2016 For Inspections please call: (305)762-4949 Page 15 of 27
James F. Biagi, P.E.
Li CONSULTING ENGINEER
November 30, 2016
Addendum December 20, 2016
City of Miami
Building Department
444 SW 2 Ave.
Miami, FL 33130
RE: Bathroom Renovation
415 NE 105 St.
Miaml, FL 33138
To Whom It May Concern,
I have been retained by the property owner to Inspect the above referenced project
to determine If the work Is In compliance with the approved permit plans, the City
Code and the FOC 2014. The project Included the renovation of bathrooms at the
property address referenced above.
The work Included the Installation of new CMU block walls In two areas, one In the
women's bathroom and another In the men's bathroom.
1 have Inspected the work at the subject property, and compared It to the approved
plans, dated August 23, 2016 and have determined the new walls have been
completed In accordance with the approved plans and in accordance with the 2014
Florida Building Code.
ADDENDUM: Please note the owner Employed a contractor to locate the dry wall
screws and the framing at the subject location. The contractor used a screw locator
to locate the attachment screws for the dry wall through the cladding which was not
removed (as methodology). The location of the screws Is In all of the studs which are
a maximum center to center distance of 16". The screws are centered vertically @ a
maximum distance of 8".
, lid fou 1>&v}0, any further questions, please contact me at 954-776-8004.
o� S C° 1•-c•"u
;Jane BI 1,P E
o, �;
�- a'vA 11100
655 W Prospect Road I Oakland Park,Florida 33309
954.776.8004 F:954.776.80151 E-mail:structural3@gmall.com
Ire
�sM°RAS o�� Miami Shores Village Pr� ? filt£rCi� ,. Ct #il
10050 N.E.2nd Avenue NE Www
Miami Shores,FL 33138-0000 M '
hF Phone: (305)795-2204p
Expiration: 01/0212017
Project Address Parcel Number Applicant
415 NE 105 Street Number: CHURCH BLDG 1122310430010 ST ROSE OF LIMA CATHOLIC CI
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
ST ROSE OF LIMA CATHOLIC CHURCH 9401 BISC BLVD (305)758-0539
MIAMI FL 33138-2970
Contractor(s) Phone Cell Phone $ 13,000.00
Valuation:
QUINTERO GENERAL CONSTRUCTIO (786)487-5738 Total Sq Feet: p
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review
Final PE Certification
Date Denied: Window Door Attachment
Type of Construction:DEMO WALL TILE AND REPLACE Occupancy Load: Tie Beam
Stories: Exterior: Slab
Front Setback: Rear Setback: Termite Letter
Left Setback: Right Setback: Framing
Plans Submitted:Yes Certification Status: Store Front Attachment
Certification Date: Additional Info: Insulation
Bond Return: Classification:Residential Drywall Screw
Fill Cells Columns
Scannin :3
Window and Door Buck
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Gelling Grid
Review Planning
CCF $7.8Invoice# CC-6-16-60322
DBPR Fee $5.856 Review Electrical
DCA Fee $5.85 06/24/2016 Check#:1177 $50.00 $381.50 Review Building
Education Surcharge $2.60 07/06/2016 Check#:1187 $381.50 $0.00 Review Plumbing
Permit Fee $390.00 Review Structural
Scanning Fee $9.00 Review Mechanical
Technology Fee $10.40
Total: $431.50
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore,I authorize the above-named o do the work stated.
July 06,2016
Authorized Signature:Owner / Applioa Contractor / Agent Date
Building Department Copy
July 06,2016 1
Miami Shores Village JUN 24 ®16
Building Department BY: I A�R
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 C
FBc 20 l y J
BUILDING Master Permit No'.
PERMIT APPLICATION Sub Permit No.
,<BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titlpholder):&. A C�JO Phone#•. �
5
Addres '+( `V tSfi� Q
City: ��'�'i 1/� State: Zi n p: �
Tenant/Lessee Name: Phone#:
Email: ,Q
CONTRACTOR:Company Name: ���- ( �A,4_at u Phone#: --25(1 V O-) _q3i
Address: ,,O '��✓ ���
City: 141 State: Zip: -5 30/y
Qualifier Name: ��Q 'o9/RI'a �R i Phone#:
State Certification or Registration#: l s! S��� Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 13,000 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration [:1 New ry[Repair/Replace F-1Demolition
Description of Work: i —In,� w ,A�y1 - JAWQ, yw_�- ®V-3
V'e:
`Zy�+.+ � Ste-9(�\�.�'.� �`9C� S t'fy..y J C�.yw�-/ y"' a's. Y�cs::+ .-."�►°�
Specify color of color thru tile:
Submittal Fee$ En® ° CA Permit Fee$ CCF$ CO/CC$
Scanning Fee$ f ®/)-_Radon Fee$ S:, Y-r— DBPR$ -Notary$
Technology Fee$ �� Training/Education Fee$ ?.�- 6� Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
Q �
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES,BOILERS,HEATERS,TANKS,AIR CONDITIONERS,ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant. As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property4s subject-to attachment.-Also;-a-certified ropy of-the recorded nutite-of-commerrcemelntmust4 paster-W 1o"Ire
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Sigjture Signature
Y4aro
OWNER or A NT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of Sv v. 20 1( by 51 day of /14A a® .20 ,by
,';Fr. k,6c La 0.'.\s-, who is personally known to 636rova-DB q•r&riep who is personally known to
me or who has produced C� as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
`���\111111111111/���/
�O...... LFOti����i
Sign:Print // ;•MMISSIoN '� Sign:
a•�.�- -- Print:
Seal: :@ Seal: ° KARLA P. GARCIA
U55849 �" MY COMMISSION p FF140421
i,�iAG• • :�• ;.��`��4*d VO ° � EXPIRES:July 10,2018
/C STATEp%N����
APPROVED BY ("P Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
SHORES G
Miami shores Village
NINE
Building Department
10050 N.E.2nd Avenue
�LORIUp` Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
Notice to Owner — Workers' Compensation Insurance Exemption
Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05
allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to
obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure:
An employer in the construction industry who employs one or more part-time or full-time
employees,including the owner,must obtain workers' compensation coverage. Corporate officers
or members of a limited liability company (LLC) in the construction industry may elect to be
exempt if:
1. The officer owns at least 10 percent of the stock of the corporation, or in the case of
an LLC,a statement attesting to the minimum 10 percent ownership;
2. The officer is listed as an officer of the corporation in the records of the Florida
Department of State,Division of Corporations;and
3. The corporation is registered and listed as active with the Florida Department of
State,Division of Corporations.
No more than three corporate officers per corporation or limited liability company members are
allowed to be exempt. Construction exemptions are valid for a period of two years or until a
voluntary revocation is filed or the exemption is revoked by the Division.
Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use
day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will
be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of
workers'compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors.
BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
Signature:
Owner
State of Florida
County of Miami-Dade
The foregoing was acknowledge before me this Z� day of __)t;v%e_ ,20
By _ Ave cLo 9,Aa, wh is ersonally kno to me or has produced
as ide �\ �����Y///�
�p1SS10N,c'
GO �b8f J9`'1l0: i
Notary: I,e"t�"_ ma`0 nor
SEAL: #FF 055949 oma;
j�t�'.'Ilrttttet!lNe�
Quintero General Contractor
8801 NW 112 TERR Hialeah FL 33018
Telf: (786)487-5738 Fax:(305)362-5966
DATE:07/05/2016
State of / 1L�'
County of �s��'c
Before me this day personally appeared A WAO i J4� who, being duly sworn,deposes and
says:
That he or she will be the only person working on the project located at:
Sworn to(or affirmed)and subscribed b me this 14 day of ri /gip
20_t6_--_,by Ae- o t it
Personally know
OR Produced Identification
Type of Identification Produced
L
�°�e� Notery public State of Florida Joanna M Feliciano doe My Commission FF 082753
Dyna Expires 01/12/2018
Stamp Name of Notary